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Cardiac Surgery and Transplantation 307

FIGURE 12.8 IABP during 1 : 2 assist. Late inflation. Note that the inflation point (IP) occurs well after the dicrotic notch (DN). Late inflation is also obvious
in 1 : 1 assist with balloon inflation well after the dicrotic notch.

FIGURE 12.9 IABP during 1 : 2 assist. Early deflation. The balloon has been deflated well in advance of the subsequent systole. The aortic pressure does
drop off (not much from non assisted diastole) but then begins to rise again before the next systole gets underway, and may even exceed the normal
end-diastolic pressure. Early deflation is also obvious in 1 : 1 assist.

important to treat alarm states promptly, to limit the Gas loss alarms
duration of balloon stasis. If interruption to pumping is Most devices will determine the severity of gas losses and
prolonged, intermittent manual inflation of the balloon classify them as slow, rapid or disconnect. In all gas loss
with a syringe is recommended (e.g. once every 5–10 states it is imperative that assessments be made to exclude
minutes). balloon rupture and helium leak into the arterial